Internal mammary artery embolization
Courtesy of Dr. Abhishek Kumar I Rutgers New Jersey Medical School
Presentation
84-year-old male with lung cancer, stage 3b (dx 2021) & type 2 diabetes presented after cardiac arrest. In the ER, he was hypotensive, started on pressor support and admitted to the ICU. CT angiogram of the chest revealed active hemorrhage in the substernal area from the left internal mammary artery.
Intervention used
Left radial access was obtained a 5 F sheath was placed. A 4 F angled catheter was used to select the left internal mammary artery. Angiography demonstrates extravasation from a distal branch (purple arrow). A 2.4 F microcatheter was used to select the distal internal mammary artery. Obsidio Embolic was used to perform embolization of the left internal mammary artery. A total of 0.3 cc of Obsidio Embolic was injected while retracting the catheter from distal to proximal. Completion angiography via the base catheter showed complete embolization of the left internal mammary artery. A still image shows Obsidio Embolic cast occluding the vessel.
Outcome
The patient stabilized and was weaned off pressor support over the next 12 hours.
Results from case studies are not necessarily predictive of results in other cases. Results in other cases may vary.